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Rev Esp Cardiol (Engl Ed). 2017 Aug;70(8):639-645. doi: 10.1016/j.rec.2017.01.005. Epub 2017 Feb 10.

Prognostic Value of the Nutritional Risk Index in Heart Transplant Recipients.

[Article in English, Spanish]

Author information

1
Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto de Investigación Biomédica, A Coruña, Spain. Electronic address: eduardo.barge.caballero@sergas.es.
2
Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain; Instituto de Investigación Biomédica, A Coruña, Spain.
3
Instituto de Investigación Biomédica, A Coruña, Spain; Servicio de Medicina Intensiva, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
4
Instituto de Investigación Biomédica, A Coruña, Spain; Servicio de Cirugía Cardiaca, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
5
Instituto de Investigación Biomédica, A Coruña, Spain; Servicio de Endocrinología y Nutrición, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.

Abstract

INTRODUCTION AND OBJECTIVES:

To study the prognostic impact of preoperative nutritional status, as assessed through the nutritional risk index (NRI), on postoperative outcomes after heart transplantation (HT).

METHODS:

We conducted a retrospective, single-center study of 574 patients who underwent HT from 1991 to 2014. Preoperative NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (body weight [kg] / ideal body weight [kg]). The association between preoperative NRI and postoperative outcomes was analyzed by means of multivariable logistic regression and multivariable Cox regression.

RESULTS:

Mean NRI before HT was 100.9 ± 9.9. According to this parameter, the prevalence of severe nutritional risk (NRI < 83.5), moderate nutritional risk (83.5 ≤ NRI < 97.5), and mild nutritional risk (97.5 ≤ NRI < 100) was 5%, 22%, and 10%, respectively. One year post-transplant mortality rates in these 4 categories were 18.2%, 25.3%, 7.9% and 10.2% (P < .001), respectively. The NRI was independently associated with a lower risk of postoperative infection (adjusted OR, 0.97; 95%CI, 0.95-1.00; P = .027) and prolonged postoperative ventilator support (adjusted OR, 0.96; 95%CI, 0.94-0.98; P = .001). Patients at moderate or severe nutritional risk had significantly higher 1-year post-HT mortality (adjusted HR, 1.55; 95%CI, 1.22-1.97; P < .001).

CONCLUSIONS:

Malnourished patients have a higher risk of postoperative complications and mortality after HT. Preoperative NRI determination may help to identify HT candidates who might benefit from nutritional intervention.

KEYWORDS:

Desnutrición; Heart transplant; Malnourishment; Nutritional risk index; Outcomes; Pronóstico; Trasplante cardiaco; Índice de riesgo nutricional

PMID:
28209304
DOI:
10.1016/j.rec.2017.01.005
[Indexed for MEDLINE]

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